Bortezomib (Velcade)

General information

Class/mechanism: Reversible inhibitor of the 26S proteasome, interfering with degradation of ubiquitinated proteins. This disrupts normal homeostatic mechansims, leading to cell death.
Route: IV, SC
Extravasation: irritant

• Use antiviral prophylaxis (such as with acyclovir (Zovirax) 400 mg PO daily or valacyclovir (Valtrex) 250-500 mg PO daily) to decrease risk of reactivating herpes zoster in patients treated with Bortezomib (Velcade)

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, Medscape, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Aggressive Non-Hodgkin lymphoma
• Follicular lymphoma
• Light-chain (AL) amyloidosis
• Mantle cell lymphoma
• Marginal zone lymphoma
• Multiple myeloma
• Plasma cell leukemia
• Transplant conditioning regimens
• Waldenström macroglobulinemia

Notable side effects

• Neuropathy

Patient drug information

• Bortezomib (Velcade) patient drug information (Chemocare)
• Patient counseling information can be found in the package insert
• Bortezomib (Velcade) patient drug information (UpToDate)

History of changes in FDA indication

• 5/13/2003: FDA approved "for the treatment of multiple myeloma patients who have received at least two prior therapies and have demonstrated disease progression on the last therapy."
• 3/25/2005: FDA approved "for the treatment of multiple myeloma patients who have received at least 1 prior therapy."
• 12/8/2006: FDA approved "for the treatment of patients with mantle cell lymphoma who have received at least one prior therapy."
• 6/23/2008: FDA approved "for the treatment of patients with multiple myeloma" (previously was only approved for patients who had received prior therapy).
• 10/8/2014: FDA approved for "treatment of patients with mantle cell lymphoma" (including first-line therapy for untreated patients; previously was only approved for patients who had received at least one prior treatment).

Also known as

LDP 341, MLN341, PS-341.